Today's Chat Transcript
single payer: While I applaud Mr. Obama's health care efforts, I was floored when he indicated a single payer option was not on the table. WHAT?
This plan is endorsed by MANY physicians as well as consumers.
If he did not think he could get the other side to agree on a single payer, then the health issue should have been tabled until it could.
Ezra Klein: And if the other side will never agree to single-payer, what then? We never reform the health-care system? We let costs grow to 100 percent of GDP? We let 100 million Americans go without health insurance?
There is a tendency, I think, for people to get invested in the political fight over health-care reform and lose sight of the reasons for health-care reform. This isn't about winning. it's about protecting people from medical bankruptcy, and insurer rescissions, and stagnant wages.
There's a good argument that single-payer is the best way to do that. But if it's not an achievable way to do that, and other approaches are achievable in the short-term...well, I wouldn't want to go to someone without insurance and explain to them that I passed on a deal that would protect them because I think we may be able to get something better in 30 years.
Washington, D.C.: How would you respond to Firedoglake's Jane Hamsher regarding her recent criticism of your statement that the public option isn't the most important part of the health care reform legislation anyway?
Ezra Klein: Like this. People should read the blog!
As a general point, Jane and I have different roles. She's doing great work organizing for the public option. I dearly hope she succeeds. But my job is to explain all this as best I can, as precisely as I can, to all of you. And the public option -- particularly as it's being discussed -- just isn't the core feature of health-care reform. It's important, but I could imagine a bad bill with a public option, and a good bill without one. In reality, I think we're moving towards a mediocre bill with a public option.
Boston: How hard is it to pass meaningful reform when the other side of the debate can run ads all day long saying "this is a government takeover of your healthcare!!"? Is Boehner still quoting statistics from the study done by a consulting group later revealed to be owned by a health insurance company? Has anyone called him directly on that? I saw he was on CNN with Blitzer the other day.
Ezra Klein: It's very hard. I was on a radio show today to correct some BS Dick Morris had said yesterday. Among his claims -- at least according to the hosts -- was that a doctor would lose his license for providing health care to someone over age 59.
Charlottesville, VA: Is there any chance parts of the Wyden-Bennet plan can be included during the reconciliation process? With so much support from across the spectrum, what's preventing discussing W-B alongside the HELP and Baucus plans?
Ezra Klein: The plan has a lot more fake support than it has real support. If every Republicans who has co-sponsored W-B would commit to voting for it, the plan might pass. But they haven't. That said, Wyden's Free Choice Act would be a huge and important addition to the current bills. More on that here.
Brooklyn, N.Y.: Given the state of negotiations right now, at what point should progressive Democrats walk away from a bill? Is the public option the line in the sand? Or is it something else?
Ezra Klein: They should not walk away from the bill. At least not from any bill I've seen. My god people, we're talking about a tax on wealthy Americans to provide health insurance to 40 million human beings! This stuff matters!
Washington, D.C.: Has the Senate set a time table for when they're going to debate Cap-and-Trade? Obviously, it will be after the recess, but I'm nervous that if they dither and delay it much later than that, they'll start to use the 2010 elections as an excuse to blow it off entirely.
Ezra Klein: I would bet a lot of money that we don't see the Senate pass a serious cap-and-trade plan before the 2010 midterms.
Washington, D.C.: If meat is contributing significantly to both health care costs and climate change, why won't anyone talk about discouraging its consumption?
Ezra Klein: I talked about it! In my column yesterday! But more specifically, it's because it's unpopular. And understandably so: No one wants to be scolded about what's on their plate. And I don't know that they should be. But it would be good if people at least understood the carbon impact of meat so they could make a more informed decision on their own.
Jackson, Wyoming: What are the considerations for Ben Bernanke's renewal for his term in office?
And his chances for term renewal, in you mind?
Ezra Klein: I think term renewal is pretty likely. He has done, by all accounts, a good job during this crisis. And there's probably something to be said for continuity at the Federal Reserve at this point in time. That said, I'm really conflicted as to whether Fed chairman should ever be reappointed, I sort of think that the position should be eight year and then out. It's not good for these guys to become economic oracles and titans.
Vienna, VA: Re: LBJ speech. Notice the monthly premium in 1965? $3. That's about $20 in today's dollar. The Part B premium is around $100 a month now. Maybe the president should do what LBJ didn't do -- be honest and say we're not really sure whether reform will save money and actually it might make things worse. Because, it could.
Ezra Klein: So your argument then is that the passage of Medicare made things worse?
Premiums went from $20 to $100 because health care got a whole lot better since the 1960s. As such, it became more expensive. That is, in the aggregate, a good thing. I like having my grandparents around. The question is how to get the most value for those dollars.
Concord, NH: Assuming that the Senate Finance Committee passes a watered-down mush of a bill negotiated with Grassley and Enzi (why Baucus chose to do this is beyond me), what happens next in the Senate? The Senate Health Committee passed a pretty good bill. I'm wondering if (hoping that) the full Senate can rely more heavily on the Health Committee bill and much less on the Finance Committee bill.
Ezra Klein: Yep. The two bills have to be reconciled with one another. And then that bill gets amended and debated on the floor. And then that bill gets reconciled with the House version. And then that bill needs to pass both chambers. Buacus's product is not the end of the process, nor near it.
Durham, NC: How do yesterday's developments affect the likelihood that reconciliation (or the threat of reconciliation) will play a role in the process moving forward?
Also, I thought BHO's town hall yesterday in Raleigh was the best I've seen him in a while: in command, convincing, fired up, etc. It reminded me of the campaign. But I'm not sure anybody outside of that auditorium was paying attention. Do you think he'll be able to take advantage of the August recess to rally people in support of health care reform?
Ezra Klein: We'll see. I've been surprised that Obama hasn't given a single big speech -- as opposed to presser or town hall -- on health care yet. He needs some way to focus the public mind on his argument. Maybe going back into campaign mode will be enough. But it's sort of like why he gave his speech on race in the aftermath of Wright: Big questions need to be answered in a big way. You can't just rely on CNN playing clips.
Washington, DC: I'm a conservative, but I also think the health care system is broken. We have screwed up incentives, don't get value when we do get care and too many people can't get care. I don't think single-payer is the answer, and I don't trust public option advocates because I know that the moment there is one they will be pushing for a single-payer. HOWEVER .. I have a hard time figuring out why I shouldn't like Wyden-Bennett. Help?
Ezra Klein: You should like Wyden-Bennett. Honestly, I think that if good-faith conservatives and good-faith liberals met up in a room to hash something out, that's what they'd end up with.
not from Montana: Should we really trust Baucus? Guy comes from a state with more cattle and sheep than humans and he rakes in dough from the health care industry. Not to mention he supported the bloated prescription drug benefit Bush tried to ram through. I'm sorry to go all "liberal east coast elitist" but I'm suspicious...
Ezra Klein: The problem is that it doesn't matter wheter you trust Baucus or not. He's not central to the process because Harry Reid likes him, or because the other senators put him there. He's central because he's the senior Democrat on the committee that controls money, Medicare, and Medicaid. So, for now, he's got the gavel.
House markup vs. Gang of Six: I trust Waxman - I think he's done a good job with a very difficult task of reconciling two significant groups within the Dem caucus. I can't say that I trust Baucus though and I'm even more worried having read Sen Enzi (R)'s comments - he wants a guarantee that Reid, Pelosi and the White House will preserve any bipartisan bill coming out of the Finance committee as is. I thought Republicans were in the minority so umm why do we need to make concessions of THIS level to them?
Ezra Klein: They shouldn't. Mike Enzi should not have veto power over health care. His party is in the minority. He was not elected president. If he wants to walk away from the process, or vote no on the final bill, he has that right.
San Antonio: Ezra, I liked your post recently on the merits of a four day (in the office) workweek. In response, a friend mentioned her fear that such a workweek would encourage the continued erosion of the barrier between work week and home/free time...in other words, if I'm working from home on Friday does that start to bleed over to Saturday and Sunday with increasing and unwanted frequency? Does a more flexible office presence actually encourage unhealthy expectations from employers about what employees will accomplish in "off hours"? As someone who posts at all hours (and occasionally interrupts his weekend for, say, a CBO report) I'm wondering what you think about some of the downsides of fully or partially telecommuting.
washingtonpost.com: The Four-Day Workplace Week
Ezra Klein: I think it's a very fair objection. I don't know if it would actually have that effect or not. But it's certainly the case that work suffuses most moments of my life, because my boundaries aren't strictly drawn. That said, it is a question of boundaries. I used to post on weekends. Now, in general, I don't. It's been a choice, and I think a good one.There's no reason other people and other workplaces couldn't do the same.
Washington, DC: What do you think is more likely in the Senate: changing the rules of the filibuster or putting committee chairs up for a vote every two years?
Ezra Klein: Definitely the committee chair reform. But it would also have much less of an impact than changing the filibuster.
Santa Fe, N.M.: I saw a report today on a study finding that organic food isn't any healthier than conventional food. Is buying organic a waste of money, in your opinion?
Ezra Klein: Honestly? Yes. It's definitely not healthier, at least not according to any study I've seen. There's some argument that it's more environmentally friendly. But it's not something that I'm convinced is worth a premium. I'd rather buy from a local farm that uses some pesticides than a major producers who has gone organic.
Rockville, Md.: Thanks for yesterday's lucid article on reducing meat consumption. I've been doing this for the past few months, not so much because I think it's wrong to eat dead flesh but for equal parts environmental and health reasons (and, yeah, I'm not crazy about the cruelties of factory farming either). My strategy has been more to add vegetables than to deprive myself of anything. The biggest surprise is how easy it is to eat fewer calories and still feel full--fiber is good for that. The other surprise is Mark Bittman's insanely delicious recipe for socca, a (vegan) chickpea pancake -- I'd be okay with never eating bacon again if I could eat socca every day.
washingtonpost.com: Gut Check: On Climate Change and Eating Meat
Ezra Klein: Bittman's book Food Matters has a lot of similar recipes, and a lot of good theory on this stuff.
Washington, D.C.: Strategically, don't the Republicans need Grassley and Enzi to slow-walk any Finance Committee deal until after August? It will be much harder for them to constantly attack the Dems on healthcare with any bipartisan deal out there.
Ezra Klein: Yep, and all indications are that they're going to do exactly that. Some sources say that Grassley and Enzi have explicitly told McConnell -- or at least been told by McConnell -- that no deal will happen before August.
Salem, Oregon: A little help: how should I respond to this question from my (anti-reform) brother? "How will the health care reform handle cancer patients and other patients who have other life threatening illnesses? The way I understand it is that the government will choose to spend the money on life support or other medical attention to keep them alive. I don't like the idea of the government choosing if I am worth keeping alive."
Ezra Klein: By asking what he's talking about. If you have private insurance, the government has no more role than it does now. If you have Medicare, then the government makes those decisions now, and it isn't proposing any changes to that process. If you couldn't afford insurance, there'll be subsidies so you can and you don't have to face cancer without protection. And if you're looking to get insurance, then the government is going to make it so insurers can't reject you for having had cancer when you were younger.
Put another way, the American Cancer Association has enthusiastically endorsed these bills. And they're pretty interested in making sure that people with cancer get help.
Oakland, CA: Why on earth aren't Obama, Reid, Pelosi, and every other leading Democrat leading off every press conference, and answering every interview question, with the phrase "up or down vote"? It seems to have worked pretty well for the Republicans when the issue was judicial confirmations, which hardly anybody sees as affecting their lives. Why isn't constant, unremitting pressure being put on centrist Senators to commit to the principle that health care reform will get an "up or down vote" in the Senate?
Ezra Klein: It's a great question.
Huntsburg, Ohio: From what I am hearing regarding the health plan Obama is promoting, this would not be the best for anyone age 59 or older since the coverage for major health problems would have to be reviewed by a panel instead of by the doctor. Is this correct?
Ezra Klein: No. This rumor is flying around, and it's totally untrue.
New York, NY: If Obama and Reid use every drop of their political capital to get all 60 Democratic senators to vote for cloture on healthcare and the bill passes, do you think their position is stronger or weaker to do the same for cloture on cap-and-trade a few months later?
Ezra Klein: Probably weaker. But it's also weaker if health-care reform fails.
Washington, DC: Always cracks me up when liberals blast the Medicare prescription drug benefit as "bloated," especially since alternatives proposed by liberals in 2003 would have been WAY more expensive. Part D has actually cost less than projected. Its greatest flaw is the doughnut hole (which, if filled, would make it.. yes... bloated) and the fact that it wasn't paid for. But as a general matter, this program really works and liberals should put their politics aside and admit it has worked well.
Ezra Klein: So far as I know, there's zero evidence that the approach favored by liberals would have been, or would currently be, more expensive. The crux of the argument here is whether Medicare could have bargained for lower rates than private insurers. I see no reason to believe they couldn't.
Silver Spring, MD: Ezra,
Sorry this post is so long. I really liked your Gut Check column yesterday. We are also trying to decrease our meat consumption; when I was a kid, we ate meat every day; when I was a teenager, we started eating more chicken, fish, and tofu. A few questions about your column:
1. Is there a difference, in terms of the environment, between cows vs. lamb and sheep? Would it be better if we started eating more lamb/sheep instead of cows?
2. What about chicken? Is this OK to eat more often, or should we try to scale back our consumption of chicken, too?
3. Why is dairy better than meat? You need the cow to live as long as possible in order to get more milk from it, so how does eating dairy help?
I ask not to criticize, but because I really am trying to do better. I still can't get my husband to eat tofu, but at least he loves beans. Thanks for the article!
Ezra Klein: 1) Pretty marginal differences there, as I understand it. Red meat is in general worse than chicken or fish.
2) Better than red meat, worse than vegetables.
3) For one thing, you tend to eat less dairy than meat. Lots of people will get an 18-ounce steak, or a half-pound burger. Fewer will eat that much cheese. And I think that producing dairy is also less carbon intensive in general.
Posted by: Steven_desJardins | July 31, 2009 4:28 PM | Report abuse
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